Outcome of assisted reproductive technology in women over the age of 41

Objective: To analyze the results of ongoing pregnancies and deliveries after assisted reproductive technology (ART) in women aged ≥41 years, stratified by year of age. Design: Retrospective study. Setting: University hospital, IVF unit. Patient(s): A total of 431 IVF and intracytoplasmic sperm injection (ICSI) cycles were initiated in women ≥41 years of age. Intervention(s): Medical files of ART patients and pregnancy outcomes were reviewed. Main Outcome Measure(s): Oocytes retrieved, embryos developed, and clinical pregnancy and delivery rates. Result(s): Of the 431 started cycles, 376 (87%) reached the oocyte retrieval stage. The mean number of oocytes aspirated per patient was 5.4 ± 0.9 and 6.7 ± 1.2 in the IVF and ICSI cycles, respectively, and the number of embryos obtained was 2.3 ± 1.3 and 2.8 ± 1.6 in the IVF and ICSI cycles, respectively. The number of transferable embryos was 2.0 ± 1.2 and 2.5 ± 0.8. The pregnancy rate per oocyte pickup (OPU) was 12.4%; however, the delivery rate per OPU was 4.5%. The mean delivery rate per OPU among women aged 41–43 years was 2%–7%. There were no deliveries aged ≥44 years and no pregnancies at the age of 45 years. The pregnancy and delivery rates of the ICSI and IVF patients were similar after stratification by age. Conclusion(s): In our studies, ART performed with homologous oocytes, whether by IVF or ICSI, yielded no clinical pregnancies among women aged ≥45 years and no deliveries aged ≥44 years. The mean delivery rate per oocyte retrieval among women aged 41–43 years varied between 2% and 7%.